Riverside County Public Health Laboratory 4065 County Circle Dr. Riverside, CA. 92503

Hours: Monday-Friday 7:30a.m.- 5:00p.m.

Accreditations CLIA California Lab MediCal Provider CAP Proficiency AAB Proficiency

Riverside County Public Health Laboratory (951) 358-5070

05D0571882 1158 195249601081 233280101 0601158

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Table of Contents

General Information

Page

Phone Numbers…………………………………………………………………………………3 Laboratory Request Form………………………………………………………………………4 Courier Pick Up Schedule for Public Health Clinics……………………………………………5 Specimen Collection Supplies- County Clinics…………………………………………………6 Specimen Submission Instruction……………………………………………………………….7 Alphabetical Test Request and Collection Guide……………………………………………….9 Detailed Specimen Collection Information….………………………………………………….30

Riverside County Public Health Laboratory (951) 358-5070

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Laboratory Phone Numbers Main Line: Fax: After hours Cell Phone:

(951) 358-5070 (951) 358-5015 (951) 538-7805

LABORATORY DIRECTOR: William Lawrence

ASSISTANT LABORATORY DIRECTOR: Megan Crumpler, PhD.

PUBLIC HEALTH MICROBIOLOGISTS: Hue-Ly (Dee) Guan Marissa Tuazon Anthony Walker Manpreet Kaur

CLERICAL STAFF: Vanessa Arreola Josephine Cortez Michele Lee SENIOR LABORATORY ASSISTANTS: Lainie Finnell

Gina Silva

Carolyn Tripp

Gisele Wilker

Riverside County Public Health Laboratory (951) 358-5070

Madeline Harper

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RIVERSIDE COUNTY COURIER SPECIMEN PICK-UP SCHEDULE (for county public health clinics) AGENCY/ DEPT

ADDRESS

Banning Family Care Center

3055 W. Ramsey Banning, CA 92220 1293 W. Hobson Way Blythe, CA 92225 505 S. Buena Vista Corona, CA 92882 880 N. State Street Hemet, CA 92543 47-923 Oasis Street Indio, CA 92201 9415 Mission Blvd. Riverside, CA 92509 2499 E. Lakeshore Drive Lake Elsinore, CA 92530 3111 E. Tahquitz Canyon Way Palm Springs, CA 92262 308 E. San Jacinto Ave. Perris, CA 92571 7140 Indiana Avenue Riverside, CA 92504 5256 Mission Blvd. Riverside, CA 92509 3865 Jackson Street Riverside, CA 92503

Blythe Health Center Corona Family Care Center Hemet Family Care Center Indio Family Care Center Jurupa Family Care Center Lake Elsinore Family Care Center Palm Springs Family Care Center Perris Family Care Center Riverside Neighborhood Health Center Rubidoux Family Care Center Parkview Community Hospital

Riverside County Public Health Laboratory (951) 358-5070

AM PICK-UP

PM PICK-UP

X X X X X X X X X X

X

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LABORATORY SUPPLIES for County Clinics Bacterial Culturettes (modified Amies -clear media)

Internal support 358-6173

Blood Serum Separator Tube- (SST) plastic only-tiger top

Internal support 358-6173

Blood tube- lavender top (EDTA anticoagulant)

Internal support 358-6173

Blood lead tube extender

PH Laboratory 358-5070

Dupont Isolator Tube – for TB and/or fungus on blood specimens GC Culturette for rectal and throat specimens (Amies with charcoal) Green tops for blood transport

PH Laboratory 358-5070 (TB) PH Laboratory 358-5070 358-5070

Laboratory Test Request forms

358-5070

Lancets for blood lead collection

358-5070

Mailing containers

358-5070

Nasopharyngeal swabs

Internal support 358-6173

Ova and Parasite (2 vials) ParaPak kit

358-5070

Pinworm paddle

358-5070

Aptima swabs (Genprobe) for CT/GC (male or female)

358-5070

Regan-Lowe slant (Bordetella pertussis)

358-5070

Salmonella & Shigella/ C&S vials

358-5070

Specimen biohazard bags

358-5070

Sterile screw cap container- 15 ml Conical

358-5070

Sterile screw cap container- 50 ml Conical

358-5070

Sterile containers for stool (Norwalk)

Internal support 358-6173

Stool transport (ParaPak C&S) for enteric cultures

358-5070

Typhoid Urine Culture (ParaPak C&S)

358-5070

Urine cups for CT/GC testing

358-5070

Viral Transport Collection for Herpes or Influenza

358-5070

Water Collection vials

358-5070

Riverside County Public Health Laboratory (951) 358-5070

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Riverside County Public Health Laboratory Specimen Submission Instructions

I.

Specimen Collection A. Collect specimen in containers appropriate for the test requested. B. Use swabs, media or collection containers with current expiration dates. C. Hold specimens under correct conditions before transport. D. Observe time restrictions on collection and transport.

II.

Specimen Identification A. Please use a computer generated label to label all specimens. This will decrease clerical errors, but if it is not possible, please submit the following information: 1. Specimen container with patient’s first and last name and date collected. 2. Anonymous HIV testing is acceptable with the identification number.

B. If computer generated label is not an option, please print legibly. III.

Test Request Form A. Please use a computer generated label to label the County of Riverside Laboratory Test Request form. If that is not possible, please include: 1. 2. 3. 4.

Patient name- legibly print the patient’s first and last name Encounter number; DOB Submitter information Date of specimen collection

B. Also required on Test Request Form 1. Test requested 2. Specimen source 3. Some tests require the date of symptom onset (norovirus).

IV.

Reference Cultures A. Please send an actively growing pure culture on solid test-tube media, B. Or MB bottle for TB ID C. Slide for Malaria ID in protective slide holder D. Please use the Laboratory Test Request form. E. Check the appropriate box on the form for “Isolate for Identification” F. Supply any additional information such as “Culture referred as…” G. Clinical history, travel history, insect bites, etc.

V.

Transport A. Ensure the integrity of specimens before transport. Secure tops on the EDTA blood lead tubes; screw urine container lids down tightly. B. All blood tubes need to be placed in a plastic conical green top tube. The green tube or other specimen container should be placed in a biohazard zip lock baggie. C. Place completed Laboratory Test Request form in outside pocket of biohazard bag. D. Place specimen in igloo (with ice, if appropriate) for courier transport to the Public Health Laboratory.

Riverside County Public Health Laboratory (951) 358-5070

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E. Specimens that are transported other than by County Courier must follow the New Transportation Requirements for Infectious Substances effective October 1, 2006. VI. Specimen Quality Assurance Criteria To assure quality testing and to meet Federal and State regulations, the Public Health Laboratory has strict requirements for specimen identification, as detailed below. All specimen requisitions received by the public health laboratory must have the following patient information required by the Clinical Laboratory Improvement Act: 1) Name or patient identifier (must match name or identifier on specimen) 2) Date of specimen collection 3) Sex 4) Date of birth A. The following specimens do not meet quality assurance standards. They will not be tested and will be resulted as “Unsatisfactory.” If you receive a report with a result of “Unsatisfactory” please collect a new specimen with new paperwork to be sent to the lab. 1. Specimen lacking patient name or anonymous HIV number. 2. Name or number on specimen not matching accompanied lab request. 3. Name or identifier missing on requisition form 4. Specimen with compromised quality: i. Collected in improper container ii. Collected in expired container or on expired media iii. Not enough specimen in the container iv. Received leaking v. If blood, clotted or grossly hemolyzed upon receipt in the lab vi. Past the acceptable collection/transport time noted for each test found below vii. Improper specimen for test requested B. The following specimens do not meet quality assurance standards. The client will receive a phone call requesting information. If we do not have the required information within three days of receipt in the lab the test will be resulted as “Unsatisfactory.” 1. Request without the following information a. Sex of patient b. Date of birth c. Date collected d. Test requested e. Source of specimen f. Lead testing requires appropriate paperwork be submitted. This usually includes test request, PM 160, and Eligibility forms.

Riverside County Public Health Laboratory (951) 358-5070

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VII. Test “Turn Around Time” (TAT) Each test listed in the Test Request and Collection Guide has a projected TAT. This is the time from specimen receipt in the Public Health Laboratory to result entered into the Laboratory Information System. This time is dependent on a non-holiday work week, courier pick up time of the specimens, time of day that the results are printed, and whether the specimen requires confirmatory testing. No TAT will be listed for Send-Out Tests.

Riverside County Public Health Laboratory (951) 358-5070

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TEST REQUEST INFORMATION – alphabetical TEST NAME

DESCRIPTION

Culture Aerobic

Identification of all relevant aerobic organisms found using conventional aerobic culture techniques. Drug susceptibilities performed if necessary at Reference Laboratory

Culture for Identification

Aerobic bacterial culture identification sent by a referring Laboratory.

(i.e. Salmonella/ Shigella)

Identification performed by utilizing conventional aerobic biochemical testing techniques.

Salmonella serotyping

Salmonella serotyping performed at *MDL.

SPECIMEN REQUIREMENTS

SPECIMEN: throat, sputum, eye, ear, genital, wounds and body fluid CONTAINER: Bacterial Culturettes or sterile collection containers COLLECTION: Sputum: expectoration obtained after a deep cough collected in sterile container. Bacterial Culturettes are used for genital, eye, ear, throat, wounds and abscesses- swab infected area. TRANSPORT CONDITIONS: Room Temperature for 24 hours (genital swabs) Refrigerated for 24hours (sputum)

NORMAL VALUE

TEST METHOD

No Growth

Culture

2-3 days

87077

87070

or Normal Flora

SPECIMEN: Pure culture isolate COLLECTION: Organism subbed to slant tube TRANSPORT CONDITIONS: Room Temperature for 3 days

SPECIMEN: Pure culture isolate or Salmonella or Shigella) COLLECTION: Organism subbed to slant tube TRANSPORT CONDITIONS: Room Temperature for 3 days

Send out to *MDL

*MDL- Microbial Diseases Laboratory Riverside County Public Health Laboratory (951) 358-5070

CPT CODES

Culture

TURN AROUND TIME (TAT) 1-4 days

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TEST NAME

DESCRIPTION

SPECIMEN REQUIREMENTS

NORMAL VALUE

TEST METHOD

TAT

CPT CODES

Culture Campylobacter

Campylobacter culture identification sent by referring Laboratory. Confirmation utilizing conventional biochemicals.

SPECIMEN: Feces in C&S container COLLECTION: The specimen of choice is the diarrheal stool collected during the acute stage of the disease. Keep the stool specimen cool, do not incubate or refrigerate. Portions containing blood or mucus usually contain the highest number of pathogens. TRANSPORT CONDITIONS: Room Temperature for 4 days (maximum for preserved stool)

Negative

Culture

3-4 days

87046

Culture Enteric

Identification of enteric organisms included including Salmonella and Shigella.

SPECIMEN: Fresh stool CONTAINER: Stool transport vials (ParaPak C&S) COLLECTION: The specimen of choice is the diarrheal stool collected during the acute stage of the disease. Keep the stool specimen cool, do not incubate or refrigerate. Portions containing blood or mucus usually contain the highest number of pathogens. TRANSPORT CONDITIONS: Room Temperature for 4 days (maximum for preserved stool)

Negative

Culture

3-4 days

87045

Riverside County Public Health Laboratory (951) 358-5070

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TEST NAME

Blood Lead Screen

Blood parasite confirmation-

DESCRIPTION

Determination of lead level in blood using Anodic Stripping Voltametry methodology.

Plasmodium speciation by microscopic exam of Giemsa or Wright -stained blood smear

exam

Culture Bordetella pertussis

DFA Bordetella pertussis

Screening procedure for isolation and identification of Bordetella pertussis utilizing conventional biochemical techniques and direct florescent antigen (DFA) testing.

SPECIMEN REQUIREMENTS

NORMAL VALUE

TEST METHOD

TAT

CPT CODES

SPECIMEN: Unclotted capillary blood drawn in EDTA COLLECTION: Fingerstick blood filled to 500 ul mark in capillary EDTA tube. TRANSPORT CONDITIONS: Refrigerate until testing is performed.

2 are positive it is considered an outbreak.

SPECIMEN: Unpreserved stool CONTAINER: Collected in a sterile container with no preservative. Container must be secured and each specimen individually bagged in a biohazard zip lock bag. Place paperwork in outside pocket. COLLECTION: Collect ASAP after symptom onset, best within 72 hours. TRANSPORT: Refrigerate and transport to laboratory on cold pack.

No Nucleic

PCR

2-3 days

87797

O&P Concentrate/ Trichrome

A concentrated wet preparation and a trichrome stain are microscopically examined for ova and parasites.

SPECIMEN: Stool. 3 collected every other day is strongly recommended. CONTAINER: Para-Pak 2-vial stool kit with 10% formalin and PVA. COLLECTION: Add stool to each vial up to the “fill” line immediately after passage. Then mix specimen thoroughly. TRANSPORT CONDITIONS: Room temperature

Negative

Microscopy

3 days

87177 87209

ID of parasite

Identification is made by microscopic exam and /or confirmed by Vector Control if necessary.

SPECIMEN: Arthropod, worm or skin scraping. COLLECTION: If arthropod is alive, place in a jar with a wet paper towel; If dead, fix with 70-95% alcohol. For skin scraping slide, place in a slide holder. TRANSPORT CONDITIONS: If arthropod is alive- Refrigerate. If dead- Room temperature. Skin scraping slide- secure in slide holder at room temperature.

By report

Microscopy

2-4 days

87169

Norovirus PCR

Riverside County Public Health Laboratory (951) 358-5070

Acid Detected.

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TEST NAME

DESCRIPTION

SPECIMEN REQUIREMENTS

NORMAL VALUE

TEST METHOD

TAT

CPT CODES

1 day

87172

Pinworm

Microscopic evaluation of pinworm paddle for eggs and/or worms.

SPECIMEN: Perianal impression CONTAINER: Pinworm paddle COLLECTION: Press the sticky side of the paddle against the perianal area. TRANSPORT: Send to the Lab ASAP. Keep at room temperature.

Negative

Microscopy

DFA Pneumocystis

Direct Florescent Antigen (DFA) detection of Pneumocystis cariniii in a respiratory specimen.

SPECIMEN: 2-3 mls. Induced sputum, bronchioalveolar lavage, and tracheobronchial aspirates. CONTAINER: Sterile container. COLLECTION: Saline induced sputum or the above specimens. TRANSPORT CONDITIONS: Refrigerate *Note - Induced sputum must be transported to the lab within 24 hours.

Negative

DFA

Prenatal Panel:

Determination of patient’s hepatitis, syphilis, and Rubella status.

SPECIMEN: Serum, 5 ml CONTAINER: Serum Separator Tube (SST), Tiger top or red top. COLLECTION: See serology specimen collection guide for details. Plastic tubes only. TRANSPORT CONDITIONS: Room temperature= acceptable Refrigerated= acceptable Frozen= -20 C, serum only

Negative

ETI MAX

Negative

DSX

86592

Positive

DSX

86762

Hepatitis B surface Antigen Syphilis EIA screen Rubella

Riverside County Public Health Laboratory (951) 358-5070

All tests done by EIA

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2 days

3 days

87281

87340

TEST NAME

DESCRIPTION

SPECIMEN REQUIREMENTS

NORMAL VALUE

TEST METHOD

TAT

CPT CODES

Negative

DSX

2 days

86480

Acceptable Titer for immunity

Send Out To *VRDL

Negative

FITC AntiRabies Conjugate

Quantiferon

Whole blood IFN-gamma test measuring response to TB antigens.

SPECIMEN: 1 mL blood (3 separate tubes) CONTAINER: Three separate tubes: Nil, TB antigen and mitogen control COLLECTION: Mix tubes by shaking vigorously for 5 sec to ensure that the entire inner surface of the tube has been coated with blood. TRANSPORT CONDITIONS: Transport tubes to the lab within 16 hours at room temperature.

Rabies Ab titer

Determination of Immune status for occupations vaccinated against the rabies virus.

SPECIMEN: Serum, 2.5 ml CONTAINER: Serum Separator Tube (SST), Tiger Top or 1 Red Top COLLECTION: See serology specimen collection guide for details. Plastic tubes only. TRANSPORT CONDITIONS: Room Temperature= acceptable Refrigerated= acceptable Frozen= -20ºC, serum only

Additional information required. Please contact laboratory. 951-358-5070 Rabies exam

Direct Fluorescent Antibody

SPECIMEN: Freshly severed animal head or whole bat delivered by Animal Care Services. CONTAINER: Any sterile transport container COLLECTION: Freshly severed animal head or whole bat. Do not place in formalin. TRANSPORT CONDITIONS: Transport to laboratory on cold pack or refrigerated within 24 hrs.

Stat testing available

Specimen must be accompanied by a completed bite report.

*VRDL- Viral and Rickettsial Diseases Laboratory

Riverside County Public Health Laboratory (951) 358-5070

Staining done on Wed/Fri

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TEST NAME Rubella

DESCRIPTION

SPECIMEN REQUIREMENTS

NORMAL VALUE

TEST METHOD

TAT

CPT CODES

Determination of immune status to Rubella

SPECIMEN: Serum, 2.5ml CONTAINER: Serum Separator Tube (SST), 1 Tiger Top or 1 Red Top COLLECTION: See serology specimen collection guide for details. Plastic tubes only. TRANSPORT CONDITIONS: Room Temperature: Acceptable Refrigerated: Acceptable Frozen: -20º C, serum only

Positive

Dynex DSX

3 days

86762

Streptococcus Group A Screen

Screening procedure for the isolation and identification of Group A (Streptococcus pyogenes) a common cause of bacterial pharyngitis

SPECIMEN: Throat exudates CONTAINER: Red Bacterial Culturette COLLECTION: Throat swab taken from the tonsil area and/or posterior pharynx, with care taken to avoid the tongue and uvula. Dacron swabs are best for collection of Group A Streptococcus specimens. TRANSPORT CONDITIONS: Room temperature for 24 hours

Negative

Culture

24-48 hrs

87081

Streptococcus Group B Screen

Screening procedure for isolation and identification of group B strep (Streptococcus agalactiae) cause of serious neonatal infections characterized by sepsis and meningitis.

SPECIMEN: Vaginal/rectal swab CONTAINER: Red Bacterial Culturette COLLECTION: Obtain secretions from the vaginal vault and rectal mucosa with a sterile swab. TRANSPORT CONDITIONS: Room temperature for 24 hours

Negative

Culture

72 hrs

87081

IgG Antibody

Riverside County Public Health Laboratory (951) 358-5070

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TEST NAME

DESCRIPTION

SPECIMEN REQUIREMENTS

NORMAL VALUE

TEST METHOD

Susceptibility testing on positive bacterial cultures.

Appropriate antibiotic susceptibilities tested on bacterial organism to determine patient treatment.

SPECIMEN: Pure culture isolate COLLECTION: Nutrient agar slant TRANSPORT CONDITIONS: Room Temperaturetransported to RCRMC via daily courier.

By report

VITEK at *RCRMC

Syphilis Confirmation

RPR qualitative and quantitative.

Negative

(RPR titer and TP-PA)

TP-PA

SPECIMEN: Serum, 2.5 ml CONTAINER: Serum Separator Tube (SST), 1 Tiger Top or 1 Red Top COLLECTION: See serology specimen collection guide for details. Plastic tubes only. TRANSPORT CONDITIONS: Room Temperature: acceptable Refrigerated: acceptable Frozen: -20ºC

VDRL

Detection of the presence of non-treponemal antibodies during syphilis infection in the CSF.

SPECIMEN: CSF, 3 – 5 ml CONTAINER: Sterile tube TRANSPORT CONDITIONS: Refrigerated and transported to the laboratory within 5 days. If transport will take more than 5 days, freeze at -20°C and transport on dry ice to the lab.

Negative

(CSF ONLY)

Riverside County Public Health Laboratory (951) 358-5070

TAT

CPT CODES

3-4 days

86593 86781

VDRL Venereal Disease Research Laboratory Slide Test

28

3 days

86592

TEST NAME Syphillis EIA Screen

DESCRIPTION

SPECIMEN REQUIREMENTS

NORMAL VALUE

TEST METHOD

TAT

CPT CODES

Detection of the presence of antibodies to Treponema pallidum

SPECIMEN: Serum, 2.5 ml CONTAINER: Serum Separator Tube (SST), Tiger Top or Red Top COLLECTION: See serology specimen collection guide for details. Plastic tubes only. TRANSPORT CONDITIONS: Room Temperature: acceptable Refrigerated: acceptable Frozen: Unacceptable

Negative

Dynex DSX

3 days

86592

Detects the presence of coliforms and E.coli in water sample.

SPECIMEN: 100mls of water sample. CONTAINER: Sterile, transparent, nonfluorescent vessel containing 10% Sodium Thiosulfate. COLLECTION and TRANSPORT: Keep water sample at refrigerated temperatures. Time between collection and examination should not exceed 24 hours.

Absent

Growth Detection

P/A- 24 hrs

SPECIMEN: Serum CONTAINER: : Serum Separator Tube (SST), Tiger Top or Red Top COLLECTION: See serology specimen collection guide for details. Plastic tubes only. TRANSPORT CONDITIONS: Room Temperature: acceptable Refrigerated: acceptable

Negative

IgM EIA with background subtraction (and if positive) IgM and IgG IFA

3-4 days

Confirmed by RPR and TP-PA if positive

Water Testing : Presence/Absence

West Nile Virus IgM Antibody

Detection of WNV IgM antibodies by EIA with background subtraction to check for cross reactions. If the sample tests EIA positive, an IgM and IgG IFA is performed. VRDL has recommended that two different assays be positive to be considered a WNV case.

Riverside County Public Health Laboratory (951) 358-5070

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86788

Mycobacteriology Specimen Collection Guide

TEST Mycobacteria culture and susceptibilities

SPECIMEN

COLLECTION

TRANSPORT

Blood

Aseptically collect 10 mls of blood using the DuPont Isolator 10 tube (available from the Laboratory)

Room temperature (15-30 degrees C). Must be received in the lab within 5 days.

Body fluids

Abdominal (peritoneal, paracentesis, dialysis, bile): Collect 10-15 ml aseptically into sterile tube. Pericardial, Synovial: Collect 3-5 ml aseptically into a sterile tube. Exudates: Collect 3-5 ml aseptically into sterile tube. Collect 3-5 ml into sterile screw-cap tube.

Refrigerated (2-8 degrees C). Must be received in the lab within 5 days.

CSF Gastric Lavage fluid

Riverside County Public Health Laboratory (951) 358-5070

Collect 5-10 ml gastric specimen in sterile container. Have the patient fast 8-12 hrs and then collect specimen in the morning before eating food. Specify time of collection on container.

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Refrigerated. Must be received in the lab within 5 days. Transport within 4 hours after collection at 2-8 degrees C. If specimen transport is delayed more than 4 hrs from collection time, add 100mg of sodium carbonate.

Mycobacteriology Specimen Collection Guide

TEST Mycobacteria culture and susceptibilities

SPECIMEN Respiratory

Stools (HIV patients only)

MTB Direct Amplification Test

COLLECTION

TRANSPORT

Collect 2-5 ml of respiratory secretion in sterile container without fixatives or preservatives: Aerosol sputum- inhalation of warm hypertonic saline induces coughing and the production of a thin, watery specimen. Aerosols are preferred. Collect in a sterile container without preservatives.

Refrigerated. Must be received in the lab within 5 days.

Refrigerated. Must be received in the lab within 5 days.

Urine

Wash the external genitalia then immediately collect 30-50 ml of a single early morning midstream urine sample into a sterile container.

Refrigerated. Must be received in the lab within 5 days.

Processed respiratory specimens

Send at least 1.0 ml of specimen processed with NALC/NaOH procedure (see CDC guidelines for procedure). Testing performed at *SBCPHL.

Refrigerated

Riverside County Public Health Laboratory (951) 358-5070

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Serology Specimen Collection Guide 1. Use only plastic blood collection tubes. 2. Do not freeze whole blood. This will cause the specimen to hemolyze and be unacceptable for testing.

SPECIMEN

COLLECTION

HOLDING/TRANSPORT

Serum

Aseptically collect 8-10 ml of whole blood in a Serum Separator Tubes (SST) or a red top. Centrifuging is recommended if a delay of more than 48 hours is anticipated prior to delivery to the lab.

Hold at 2 to 22 degrees C until transportation to the laboratory. Transport to the laboratory within 2-4 days of collection with cold pack.

Serum, Acute

Acute-phase specimens should be collected as soon as possible, no later than 5-7 days after onset of the disease. Aseptically collect 8-10 ml of whole blood in one of the following Serum Separator Tubes (SST) or a red top tube. Centrifuging is recommended if a delay of more than 48 hours is anticipated prior to delivery to the lab. Label lab slip and specimen as acute. Convalescent-phase specimens are usually collected 10-14 days after acute-phase specimens. Aseptically collect 8-10 ml of whole blood in Serum Separator Tubes (SST), or a red top tube. Centrifuging is recommended if a delay of more than 48 hours is anticipated prior to delivery to the lab. Label lab slip and specimen as convalescent.

Hold at 2 to 22 degrees C until transportation to the laboratory. Transport to the laboratory within 2-4 days of collection with cold pack.

Serum, Convalescent

Riverside County Public Health Laboratory (951) 358-5070

Hold at 2 to 22 degrees C until transportation to the laboratory. Transport to the laboratory within 2-4 days of collection with cold pack.

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Virology Specimen Collection Guide

SPECIMEN

COLLECTION INSTRUCTIONS

TRANSPORT

Nasal Swabs

Using the Viral Transport Pack swab, collect the nasal specimen, insert the swab into the vial, break off the shaft of the swab and cap tightly.

Transport to lab as soon as possible, no later than 96 hours, at 2-8 degrees C. Specimens that cannot be transported within 96 hours should be frozen at 70 degrees C and transported on dry ice.

Nasal washings

While the patient’s head is tilted back slightly, instill several ml of sterile saline into each nostril; bring the head forward and allow the saline to drain into a small sterile container held beneath the nose. A small catheter with suction may be used with infants. Pour the contents into a sterile, screw cap vial. Using the Viral Transport Pack swab, collect the pharyngeal/throat specimen, insert the swab into the vial, break off the shaft of the swab and cap tightly.

Transport to lab as soon as possible, no later than 96 hours, at 2-8 degrees C. Specimens that cannot be transported within 96 hours should be frozen at 70 degrees C and transported on dry ice.

Collect specimens of vesicle fluids from the bases of lesions before crusting and healing have begun. For aspirates of vesicular fluids, use a 26-27 gauge needle attached to a tuberculin syringe or a sterile capillary pipette to aspirate clear vesicular fluid. Use a Viral Transport swab to obtain both fluid and cells from open lesions. Place the swab in the vial, break the shaft of the swab and cap tightly. .

Transport to lab as soon as possible, no later than 96 hours, at 2-8 degrees C. Specimens that cannot be transported within 96 hours should be frozen at 70 degrees C and transported on dry ice.

Pharyngeal/Throat swabs

Vesicle fluids, lesions, and skin scrapings

Riverside County Public Health Laboratory (951) 358-5070

Transport to lab as soon as possible, no later than 96 hours, at 2-8 degrees C. Specimens that cannot be transported within 96 hours should be frozen at 70 degrees C and transported on dry ice.

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Gen-Probe Aptima Assay Specimen Collection Guide - Tigris SPECIMEN

COLLECTION INSTRUCTIONS 1. Remove excess mucus from the cervical os and surrounding mucosa using the cleaning swab (white shaft swab). Discard the swab. A large-tipped swab (not provided) may also be used to remove excess mucus. 2. Insert the specimen collection swab (blue shaft swab) into the endocervical canal. Gently rotate the swab clockwise for 10-30 seconds in the endocervical canal to ensure adequate sampling.

Genital Swab – Female Swabs need to be transported to the laboratory in the swab specimen transport tube at 2°C to 30°C within 6 days.

3. Withdraw the swab carefully; avoid any contact with the vaginal mucosa. 4. Remove the cap from the swab specimen transport tube and immediately place the specimen collection swab into transport tube so that the tip of the swab is visible below the tube label. 5. Carefully break the swab shaft against the side of the tube at the score line and discard the top portion of the swab shaft; use care to avoid splashing of contents. 6. Tightly screw the cap onto the tube. 7.

Label tube with patient name, medical record number, date, and time. Place tube in biohazard specimen bag and seal. 1. The patient should not have urinated for at least 1 hour prior to sample collection. 2. Insert the specimen collection swab (blue shaft swab) 2 to 4 cm into the urethra. Gently rotate the swab clockwise for 2 to 3 seconds in the urethra to ensure adequate sampling.

Genital Swab – Male Swabs need to be transported to the laboratory in the swab specimen transport tube at 2°C to 30°C within 6 days.

3. Withdraw the swab carefully. 4. Remove the cap from the swab specimen transport tube and immediately place the specimen collection swab into transport tube so that the tip of the swab is visible below the tube label. 5. Carefully break the swab shaft against the side of the tube at the score line and discard the top portion of the swab shaft; use care to avoid splashing of contents. 6. Tightly screw the cap onto the tube. 7. Label tube with patient name, medical record number, date, and time. Place tube in biohazard specimen bag and seal.

Riverside County Public Health Laboratory (951) 358-5070

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Gen-Probe Aptima Assay Specimen Collection Guide - Tigris SPECIMEN

COLLECTION INSTRUCTIONS 1. The patient should not have urinated for at least 1 hour prior to specimen collection. 2. Collect specimen in a sterile, plastic, preservative-free specimen collection cup. 3. Instruct patient to collect 20 to 30 ml of first-catch urine (the initial urine stream NOT mid-stream).

Urine Processed urine specimens must be transported to the laboratory at 2°C to 30°C within 6 days.

4. Label the collection cup with patient name, medical record number, date, and time. 5. Remove the cap and transfer 2 ml of urine into the urine specimen transport tube using a disposable pipette. The urine level should be between the two black fill lines on the tube (referred to as minimum and maximum fill lines). The urine level must not be below the minimum fill line or above the maximum fill line. 6. Tightly screw the cap onto the tube. This is now known as a processed urine specimen. 7. Label tube with patient name, medical record number, date, and time. Place tube in biohazard specimen bag and seal. Dispose of excess urine in appropriate manner.

Riverside County Public Health Laboratory (951) 358-5070

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